THE SENATE

S.B. NO.

467

THIRTIETH LEGISLATURE, 2019

S.D. 1

STATE OF HAWAII

 

 

 

 

 

 

A BILL FOR AN ACT

 

 

MAKING AN APPROPRIATION TO RESTORE ADULT DENTAL BENEFITS TO MEDICAID ENROLLEES.

 

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

 


     SECTION 1.  The legislature finds that oral disease is a significant health problem among many Hawaii residents, affecting their overall health and well-being.  Access to regular oral health care varies greatly across the State, with rural and neighbor island residents and persons with low-income families experiencing greater access issues.  Lack of access to dental coverage and oral health care is a social justice issue that disproportionately affects the poor, children, the elderly, and racial and ethnic minority groups.

     Poor oral health can have serious adverse impacts and is linked to an array of acute and chronic health conditions, including heart disease, diabetes, stroke, depression, low birth weight, and premature birth, among others.  Poor oral health can negatively affect employment and the economic strength of the State and impact an individual's health status and self-image.  Untreated dental disease can result in a loss of productivity in the work place due to absenteeism, under-employment, and unemployment.  Tooth decay is almost completely preventable; however, people who are unable to see a dental provider do not receive the preventive services, early diagnoses, and interventions that can halt or slow the progression of most oral diseases.  Problems that could have been addressed early, or even prevented, continue to progress, leading to lower quality of life and poor health outcomes.  Dental care coverage is positively associated with access to and utilization of oral health care.  Research indicates that children and adults with dental coverage are significantly more likely to seek and use regular dental services than those who are uninsured.

     Having dental benefits is a key factor in an individual's ability to access dental care.  Individuals enrolled in medicaid have an increased likelihood of health disparities.  The prevalence of dental disease and tooth loss is disproportionately high among low-income populations.  Insufficient coverage or access to care often further disadvantages medicaid recipients, potentially driving worse health outcomes and higher costs.  Expanded adult dental benefits can have tremendous positive impacts on state medicaid populations:  It has been shown that individuals with dental benefits are forty-two per cent more likely to have a dental checkup within the year than individuals who do not have coverage.  Parents who receive dental care are also more likely to take their children to the dentist as well.

     Nationally, studies have shown that reducing or eliminating medicaid adult dental benefits has led to significant increases in dental-related emergency room visits and associated costs.  Ensuring that low-income adults have access to comprehensive dental coverage can improve employability and can lead to better health management.

     Medicaid provides state and federally-financed health care coverage to certain groups of people with low incomes, including children and their parents, pregnant women, the elderly, and persons with disabilities.  Although comprehensive dental coverage is mandatory for children enrolled in medicaid, dental benefits for medicaid-eligible adults are optional.  As a result, medicaid adult dental coverage varies tremendously across states.  Most states provide only limited or emergency-only coverage; Hawaii is one of thirteen states that cover dental care only for pain relief or emergency care for injuries, trauma, or extractions.

     According to a 2015 report from the American Dental Association, dental visits to emergency rooms nationwide continue to increase.  In 2012, emergency room dental visits cost the United States health care system $1,600,000,000, at an average cost of $749 per visit.  The report also estimated that up to seventy-nine per cent of emergency room dental visits could be diverted to community settings saving about forty-eight per cent of the cost of each visit.  In 2016, there were nearly five thousand emergency room visits related to dental problems in the State, costing more than $6,600,000, a cost that more than doubled since 2007.  Data indicated that medicaid recipients made up more than half of emergency room visits related to dental care.  Data also indicated that rural residents of the State, primarily from the north shore of Oahu and the islands of Kauai and Hawaii, were more likely than urban residents to go to the emergency room for dental problems.

     Adding expanded dental services benefits for the State's adult medicaid enrollees will reduce the number of acute oral health-related emergency room visits and improve these individuals' chronic disease risks and overall health status.  Current estimates on costs of restoring expanded benefits to adult medicaid recipients in Hawaii range from $500 to $1000 per year per adult, providing a range of preventive and restorative benefits for recipients to help maintain and improve their oral health.

     It has been nearly a decade since the State removed all but emergency medicaid adult dental benefits.  The legislature finds that it is in the best interest of the State and its residents to expand access to care by restoring dental benefits to adult medicaid enrollees.  Accordingly, the purpose of this Act is to appropriate funds to restore diagnostic, preventive, and restorative dental benefits to adult medicaid enrollees.

     SECTION 2.  There is appropriated out of the general revenues of the State of Hawaii the sum of $100,000 or so much thereof as may be necessary for fiscal year 2019-2020 and the same sum or so much thereof as may be necessary for fiscal year 2020-2021 to restore preventative and restorative adult dental benefits to medicaid enrollees; provided that the department of human services shall obtain the maximum federal matching funds available for this expenditure.

     The sums appropriated shall be expended by the department of human services for the purposes of this Act.

     SECTION 3.  This Act shall take effect on July 1, 2050.



 

Report Title:

DHS; Medicaid; Adult Dental Benefits; Appropriation

 

Description:

Makes an appropriation to the Department of Human Services to restore adult dental benefits to medicaid enrollees.  Requires federal matching funds.  Effective 7/1/2050.  (SD1)

 

 

 

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